What to Expect at Your Gynecologic Visit

When to see your OB/GYNHave you ever been to an obstetrician/gynecologist or Ob/Gyn for a pelvic exam and Pap test? If your answer is "no" and you are 21 or older, pick up your phone today and make an appointment with your doctor or a family planning clinic in your area. On the other hand, if your answer is "yes," then how long has it been since your last Pap smear and pelvic exam? All women should have annual Pap smears beginning at age 21, according to the American College of Obstetricians and Gynecologists. Women 21 to 29 should get a Pap every year, then every other year (or as often as your doctor recommends) from ages 30 to 64.

Teenage girls should see an OB/GYN between the ages of 13 to 15. While pelvic exams are rarely required during this first visit, this visit helps to establish a relationship with the doctor of your choice and to go over your medical and sexual history (even if you have not had sexual intercourse.)

While a yearly Pap smear is not, in most cases, necessary after age 30, all women still require an annual pelvic exam to check for any other changes or infections. If you've had an HPV test that was negative that doesn't mean you don't need to have a yearly pelvic exam. The ACOG established these guidelines with full knowledge that HPV causes cervical cancer. The greatest single reason for the occurrence of cervical cancer is not having Pap smears according to recommended guidelines. The majority of women diagnosed with cervical cancer have not had a Pap smear in five or more years. Sadly, these women are usually at an advanced stage of cancer when they receive diagnosis.

Preparing for Your Annual Pap Smear and Pelvic ExamThe best time to schedule your annual pelvic exam and to obtain the most accurate results from your gynecological examination and annual Pap smear is one or two weeks after your period. Vaginal douching is never a good idea, because of the risk of infection it presents. It is particularly important not to douche for at least two or three days before you see your gynecologist. You also should refrain from sexual intercourse for at least 24 hours prior to your examination. Make sure to empty your bladder just before your exam for a more comfortable examination. You may also want to keep a health diary that you can go over with your doctor during your appointment. You can use a calendar to keep track of your periods, any pain experienced, discharges, or other symptoms that occur during the month.

If you're annual pelvic exam is the only doctor you see on a regular basis, as it is for 24 percent of women, your gynecologist may order routine tests, such as urinalysis, cholesterol, and blood sugar levels, as well as others.

What Happens During an Annual Pap Test and Pelvic Exam?The first thing that usually happens during your annual exam is getting checks of your blood pressure, weight, pulse, and often urine. Be prepared to give the nurse the date of your last period -- this is the date of the first day of your last period. Also go over any concerns that you want to discuss with the doctor.

After your initial discussion with the nurse, you'll be directed to take all of your clothes off. Most gynecologists provide a short examination gown and a paper sheet to cover yourself until your examination begins. When you're finished, and sitting on the exam table, your gynecologist comes in, accompanied by the nurse. A female nurse should always be present during your annual exam, particularly if your gynecologist is male. The presence of the nurse provides protection for both you and your gynecologist. Your physician will listen to your heart and lungs, check your breasts for any changes or lumps, and palpitate your abdominal area for any irregularities. A reliable examination of your breasts takes approximately 30 seconds per breast. During your breast examination your physician should discuss monthly breast self- exam with you and also provide instructions if you are unfamiliar with how to perform BSE. If you are 35 or older, your physician should also discuss mammogram screening for breast cancer.

During the pelvic exam/ Pap smear portion of your visit, you'll need to lay down on the table and put your feet in the stirrups. You may need to scoot down to the end of the table and spread your knees apart. Next a speculum is inserted into your vagina to hold your vaginal walls open so your physician can view the inside of the vaginal walls and the cervix, and collect a sample of cervical tissue for your Pap test. Obtaining the Pap smear requires that your gynecologist insert a long cotton swab into your vagina. The cotton swab gently swabs against your cervix so that a sample of cervical cells is retrieved for evaluation by a pathologist. Labs generally require about five days for your test results to return to your gynecologist.

What is the Bimanual Exam?Another part of your annual pelvic exam is called a bimanual exam. This test is performed when your gynecologist inserts two fingers into your vagina and places the other hand on top of your lower abdomen, while feeling for any abnormalities that might have occurred since your last pelvic exam. During this part of your examination, your doctor checks the size, shape, and mobility of your uterus. Changes in your ovaries, such as ovarian cysts may be detected during the bimanual exam, as well as other uterine changes including endometriosis, fibroid tumors, or other common uterine conditions.

Source: http://womenshealth.about.com/od/gynecologicalhealthissues/a/gyn101.htm